Review Note

Last Update: 02/18/2024 05:30 AM

Current Deck: Part 2::6. High Yield Questions::Clinonc

Published

Currently Published Content


Front
In general, what are the components of a comprehensive geriatric assessment? Discuss the advantages and disadvantages of using such a tool.
(4 marks)
Back
Important components
  • Medical history: detailed review of the patient's medical history, including chronic conditions, past surgeries, medications, allergies, and immunizations.  
  • Physical examination: thorough evaluation of physical health, including vital signs, neurological assessment, mobility, strength, balance, sensory function, and evaluation of chronic conditions.  
  • Medication review: comprehensive review of medications to assess appropriateness, potential interactions, adherence, and the risk of adverse effects. 
  • Functional assessment: evaluation of activities of daily living (ADLs) and instrumental activities of daily living (IADLs), assessing the patient's ability to perform tasks like bathing, dressing, toileting, managing finances, and meal preparation.  
  • Cognitive assessment: screening for cognitive impairment using tools like the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), or other validated tests to assess memory, attention, and executive function.  
  • Nutritional assessment: evaluation of nutritional status, including weight changes, dietary habits, appetite, risk of malnutrition, and potential barriers to nutrition.  
  • Psychosocial assessment: assessment of psychological well-being, mood, social support systems, depression, anxiety, coping mechanisms, and quality of life.  
  • Sensory assessment: evaluation of sensory function, including vision and hearing, to address potential impairments affecting daily activities and quality of life.  
  • Advance care planning: discussion about advance directives, end-of-life care preferences, and goals of care to ensure alignment with the patient's wishes.  
  • Environmental assessment: evaluation of the patient's living environment, safety, accessibility, and potential hazards that might affect their well-being. 
  • Disadvantages:
    • May be time consuming and not feasible for all patients
    • Consider abbreviated tools eg PGA, G8, VES-13, clinical fralty score (CFS)
  • Possible benefits:
    • Predicting complications and S/Es from treatment
    • Predicting functional decline during treatment
    • Estimating survival
    • Assisting in cancer treatment decisions
      • Avoiding age bias in terms of de-escalating treatment.
    • Detecting problems not found by routine history and physical examination
    • Identification and treatment of new problems during follow up and care
    • Improving mental health and wellbeing 
    • Better pain control
Further information, not for memorising (no card)
Exam

Current Tags:

#geriatric

Pending Suggestions


No pending suggestions for this note.